Abstract
BACKGROUND: During the COVID-19 pandemic many countries reported a decline in stroke volumes. The aim of this study was to analyze if the decline was related to intensity of the COVID-19 pandemic.
METHODS: We compared the first pandemic year (March 1, 2020, to February 28, 2021) overall and during the three COVID-19 waves with the preceding year. Volumes of acute ischemic stroke (AIS), subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), and recanalization treatments [intravenous thrombolysis (IVT) and mechanical thrombectomy (MT)] were obtained from the National Register of Reimbursed Health Services.
Door-to-needle time (DNT), onset-to-door time (ODT), and NIHSS at admission were obtained from RES-Q. RESULTS: During the pandemic year as compared to the preceding year there were 26,453 vs 28,771 stroke admissions, representing an 8.8% decline (p<0.001).
The decline (-10%, -11%, -19%) appeared in all COVID-19 waves (spring 2020, autumn 2020, winter 2021), except for an increase (2%) during summer 2020. Admissions for AIS declined by 10.2%, p<0.001), while hemorrhagic stroke volumes were minimally decreased.
The absolute volumes of IVT and MT decreased by 9.4% (p<0.001) and 5.7% (p=0.16), respectively. However, the proportions of ischemic stroke patients receiving IVT (18% vs 18%; p=0.72) and MT (6% vs 6%; p=0.28) remained unchanged.
CONCLUSIONS: There was a decline in stroke admissions, but such decline was not related to COVID-19 incidence. The frequency of use of recanalization procedures (IVT, MT) and times (ODT, DNT) in AIS were preserved in the Czech Republic during the first year of the pandemic.